PicoSure Laser Treatments


The state-of-the-art PicoSure laser is a revolution that is taking medical skin treatments to new heights with many benefits compared to other modalities. This very rapid laser stimulates collagen, decreases pigment and improves texture, all in one treatment. Other advantages are minimal downtime and almost all skin types can be safely treated. Furthermore, treatments are comfortable and require no anaesthetic or analgesics. Client satisfaction is extremely high as results are impressive with minimal risk.

How does the PicoSure laser work?

PicoSure uses a FOCUS Lens Array, which targets just above the dermal-epidermal junction, exactly to the level which is most beneficial to reduce wrinkles and decrease pigmentation with the least downtime possible. These fractionated laser beams (measured in picoseconds, which are one trillionth of a second) are faster than other lasers used in the past. Also, the PicoSure laser breaks up pigmentation with pressure waves rather than heat. Why is this fact so important? When our pigmented target is stubborn and difficult to treat (such as melasma), or when our skin type is darker (like Asian, olive-toned or darker skin types), this laser does the job with much less risk than other modalities.

What can we treat with a PicoSure laser?

When targeting deep, dense, stubborn pigment such as Asian pigment, melasma, tattoos and other difficult-to-treat pigmentation, the PicoSure laser is second to none. Originally designed as a tattoo removal laser, the benefits of picosecond laser treatments were recognized and capitalized more so as an extremely effective anti-aging treatment. We also treat acne scars, surface texture, lines, wrinkles and crepey skin.

What are the results seen with PicoSure lasers?

Clients rave about their glowing skin, even after their first treatment. This glow and radiance is visibly seen immediately after the treatment and continues to impress in the coming days and weeks. They also enjoy a reduction of pigmentation gradually with each treatment, as well as a reduction in lines, wrinkles, acne scars and irregularities in skin tone and texture. Clients often report they need less or no makeup to hide pre-existing flaws.

How many treatments are needed?

We usually recommend three to four treatments, six weeks apart for most skin concerns. Benefits of glowing skin usually are visible even after the first treatment, so compliance with a series of treatments is high.

What are the risks or side effects?

As with most medical skin treatments, potential risks should be weighed against the benefits, and the client must be thoroughly informed. The risk of hyperpigmentation is present, although much less than with traditional lasers. The risks of blisters or burns exist as with most lasers, although it is a low risk. The treatments must be conducted by highly trained individuals in a medical skin clinic that is well versed in laser treatments.

What is expected after the PicoSure treatments?

Immediately after the treatment, most clients will have some redness that lasts anywhere from one hour to 24 hours. Fair-skinned clients experience less redness for less time than darker-skinned clients. An ice pack is suggested for the first 24 hours on an as-needed basis. Clients usually do not need to take time off work but are instructed to avoid overheating and exercise for the first 24 to 48 hours. Occasionally clients may experience small pustules that look like tiny acne pimples. These are transient, lasting only a few days, and they clear up spontaneously.
One of the most noteworthy benefits is that glowing skin is commonly reported, often immediately after the first treatment. A reduction in pigmentation, however, is more gradual, with fading over the next few weeks. The initial treatment may not reveal a huge reduction if pigmentation is moderate or severe, but most clients notice a decrease even after the first treatment. After the second treatment, pigmentation is usually much reduced and continues to improve after the third and fourth treatments. Expectations must be clearly outlined. Lines/wrinkles, crepey skin and acne scars gradually reduce with each treatment as new collagen and elastin is stimulated. This stimulation and regeneration takes time, usually six to eight weeks, and skin texture gradually improves.

How does PicoSure compare to other skin treatments?

PicoSure has revolutionized the medical esthetic industry because it accomplishes so much more than most other available treatments and it has many benefits, all in one treatment and with no downtime. The most common treatments that PicoSure can replace are:

1. Intense Pulse Light (IPL)

This technique is otherwise known as Photorejuvenation. It has been the “bread and butter“ of many medical esthetic treatments for almost two decades. IPL treats the superficial skin, targeting redness, brown spots and stimulating collagen. It is still one our favourite “go-to” treatments, especially for lighter skin.
PicoSure can treat deeper into the skin than IPL, however, so it has become our first recommendation for clients who have darker skin types. PicoSure carries much less risk than IPL for hyperpigmentation and brown spots.
One of the few issues PicoSure laser does not address is redness of the skin. For clients with rosacea, we primarily recommend IPL. For clients with redness but not rosacea, they can still benefit from PicoSure treatments for pigmentation, acne scars or skin rejuvenation, followed by IPL to target redness.

2. Fraxel Laser

For deep pitted scars, if the skin type is fair and not at high risk for hyperpigmentation, we may suggest the Fraxel laser. The client must be instructed that the Fraxel laser results in two to three days of redness and swelling that is significant enough to require time off work and activities. If the skin tone is darker or if there is any melasma present, however, we would suggest PicoSure.

3. Microneedling

Most clients who choose microneedling are usually on a budget and don't mind some downtime (usually two to three days of redness and swelling) to address acne scars or skin irregularities.

4. Microdermabrasion, Chemical Peels, OxyGeneo or Other Skin Treatments

These other skin treatments are very beneficial and can be used in conjunction with PicoSure, but they cannot achieve comparable results. Microdermabrasion, chemical peels and OxyGeneo are all great to exfoliate the skin, treating the superficial surface to give smoother, brighter, fresher skin. The PicoSure laser is treating the tissue at a much deeper level to achieve changes at the dermal-epidermal junction. We usually recommend alternating treatments every three weeks; we may start with one OxyGeneo treatment or chemical peel to exfoliate the skin, followed in three weeks by one PicoSure treatment. A series of three to four alternating treatments is then suggested along with medical-grade skincare products for optimal results.

How do you choose the best treatment for each client?

Each client is unique, so a personal consultation and customized treatment plan is crucial. Clients are assessed for their skin type, skin quality and skin concerns, along with their lifestyle and ability to accommodate downtime. As well, the client's budget and their expectations for improvement must be determined. The cost for a single PicoSure treatment usually is around $800, and package prices are available. Although PicoSure is suitable for most clients, alternative treatments may need to be considered. Clients should choose their treatment provider carefully and have all benefits, risks and options discussed. Educating each client in a personal consultation will allow the client to be comfortable in choosing the safest and most appropriate treatment for their skin.





Author: Dr. Diane Wong, MD, is the owner and founder of Glow Medi Spa, with three convenient and luxurious locations in the Greater Toronto Area: Yorkville (downtown Toronto), Aurora and Markham, Ontario. Glow Medi Spa was voted as the Top Medi Spa in Canada for the past two consecutive years and Top 25 Spa in Canada for the past three consecutive years. Glow Medi Spa also received the Business of the Year Award in 2018. www.glowmedispa.ca



by Dr. Diane Wong | Winter 2018